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Stress echocardiography in the assessment of coronary artery stenosis in patients with stable coronary heart disease

Surnina OV1,2*,Ponomareva IA1,Zaitsev DS1,Smetanin MYu1,Sosnovskikh MS1,Lamonova IE1,Sedelnikov AM1,Efremova Yu D2* and Osipov DR2

1The Republican Clinical Diagnostic Center of the Ministry of Health of the Udmurt Republic, Izhevsk
2 Izhevsk State Medical Academy, Izhevsk

*Corresponding author

*Efremova Yu D, Izhevsk State Medical Academy, Izhevsk, Russia

Mini Review

Objective: assessment of the significance of coronary artery stenosis by stress echocardiography (stress EchoCG).

Materials and Methods: The study included 1529 people with stable coronary heart disease (CHD). All patients underwent stress echocardiography with pharmacological (dobutamine) or physical (bicycle ergometer (BEM), treadmill) load to assess the condition of the myocardium, before the study, each patient had their blood pressure measured to determine the presence of hypertension. Some patients – 1212 (79.27%) underwent coronary angiography.

Results: Arterial hypertension of varying degrees was detected in 53.83% of the examined patients. According to the results of stress echocardiography, 996 (65.17%) patients had a positive test (no increase in contractility), coronary artery stenosis of more than 50% was detected in 530 (53,21%) of them. The majority also had diastolic dysfunction of the left ventricle (98.41%). Normal diastolic function was detected in 1.59% of the examined patients, only twelve of them underwent coronary angiography, according to the results of which stenosis of the anterior interventricular branch was detected. The accuracy of the method was 92,72%, sensitivity – 93,81%, specificity – 72,02%.

Conclusion: Stress echocardiography has demonstrated a fairly high level of accuracy, sensitivity and specificity, which indicates the need to perform this procedure in all patients with suspected coronary heart disease with an average and high pre-test probability in order to reduce the number of coronary angiographic studies.

Keywords: Stress Echocardiography, Coronary Angiography, Coronary Heart Disease, Stenosis

When conducting ROC analysis to determine the sensitivity and specificity of stress echocardiography in relation to the assessment of coronary artery stenosis, it was found that the reliability of the method was 92.72%, sensitivity – 93.81%, specificity – 72.02%, p<0.001 (Figure 1).

Table 1: Age of patients who underwent stress echocardiography and coronary angiography.

Table 2: Number of patients with arterial hypertension according to classification of arterial pressure levels.

Table 3: Presence of coronary artery stenosis in patients with a positive stress echocardiography test.

Table 4: Assessment of diastolic function of the left ventricle during stress echocardiography.

Figure 1: ROC analysis curve for assessing the sensitivity and specificity of stress echocardiography..

REFERENCES

  1. Kalandarov DM (2021) Modern possibilities of stress echocardiography in examination of patients with ischemic heart disease. Economy and society. 6: 78–96.
  2. Donal E, Panis V, Kosmala W (2021) Exercise stress echocardiography: a great tool that can be adapted to the clinical question? Open Heart. 8 (1): 1–2.
  3. Ivanov SI, Alekhin MN (2023) Practical application of non-invasive left ventricular functional parameters in diagnosis of stable coronary artery disease. Russian Journal of Cardiology and Cardiovascular Surgery 16 (1): 12–16.
  4. Cotrim CA, Café H, João I, Cotrim N, Guardado J, et al. (2022) Exercise stress echocardiography: Where are we now? World J Cardiol 14(2): 64–82.
  5. Elkanova MM, Shitov VN, Botvina UV, Lopukhova VV, Saidova MA, et al. (2017) Stress Echocardiography in the Assessment of Long-Term Outcomes After Percutaneous Coronary Intervention in Patients with Stable Coronary Heart Disease. Kardiologia 57(7): 13–19.
  6. Hirasawa K, Izumo M, Akashi YJ (2023) Stress echocardiography in valvular heart disease. Front Cardiovasc Med 10:
  7. Clinical practice guidelines (2024) «Stable coronary artery disease».
  8. Dong L, Liu J, Qin Y, Yang WJ, Nie L, et al. (2023) Relationship between ambulatory arterial stiffness index and the severity of angiographic atherosclerosis in patients with H-type hypertension and coronary artery disease. Clin Exp Hypertens 45(1): 2228517.
  9. Clinical practice guidelines "Stress echocardiography: the agreed opinion of the EEA experts".
  10. Galderisi M (2005) Diastolic dysfunction and diastolic heart failure: diagnostic, prognostic and therapeutic aspects. Cardiovasc Ultrasound 3: 9.

JCMCRI
ISSN: 3064-8025

Journal of Clinical & Medical Case Reports, Images (JCMCRI) ISSN: 3064-8025 is a peer-reviewed journal dedicated to publishing clinical images from all sectors of medicine. The goal of this magazine is to disseminate information about new discoveries and treatments in science and medicine.

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